Family Intensive Care Unit Syndrome: An Integrative Review

Yaser Saeid, Mohammad Mahdi Salaree, Abbas Ebadi, Seyed Tayeb Moradian

Abstract


Background: Hospitalization in the Intensive Care Unit (ICU) brings about psychological and physical symptoms in patients’ family members. Family Intensive Care Unit Syndrome (FICUS) is a term used to explain the psychological symptoms of the family of a patient in response to the patient’s admission to the ICU. The purpose of this study was to define FICUS along with its symptoms and predictors.

Materials and Methods: The Web of Science, PubMed, Scopus, Google Scholar, and SID databases were searched for literature published in 2005–2018 with the keywords “FICUS,” “intensive care unit,” “family,” “caregivers,” “anxiety,” “depression,” and “post‑traumatic stress disorder” in their title and abstract. The strategy for conducting an integrative review provided by Whittemore and Knafl (2005) was used in this study.

Results: Twenty articles were included in the final data analysis. Following the patient’s admission to the ICU, family members experience multiple psychological symptoms such as FICUS. The most commonly reported symptoms were anxiety, depression, post‑traumatic stress disorder (PTSD), complicated grief, sleep disorder, stress, and fatigue. The low education level, having a critically‑ill spouse, adequate support, financial stability, preference for decision‑making, understanding of the disease process, anxiety, depression, or previous acute stress were predictors of FICUS.

Conclusions: On the basis of the results, families also experience physical symptoms, so the FICUS is not limited to the occurrence of psychological symptoms. This study found that there is no universal definition for the term “FICUS” in the research literature. Thus, further research is needed to explore FICUS in the health field.


Keywords


Anxiety, depression, family, intensive care units

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References

Latour JM, Coombs M. Family centred care in Intensive Care: Moving the evidence forward A call for papers. Intensive Crit Care Nurs 2017;42:1 2.

Moradian ST. Family centered care: An evolutionary concept analysis. Int J Med Rev 2018;5:82 6.

Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: Postintensive care syndrome–family. Crit Care Med 2012;40:618 24.

Loiselle CG, Gélinas C, Cassoff J, Boileau J, McVey L. A pre–post evaluation of the Adler/Sheiner Programme (ASP): A nursing informational programme to support families and nurses in an intensive care unit (ICU). Intensive Crit Care Nurs.2012;28:32 40.

Petrinec AB, Daly BJ. Post traumatic stress symptoms in post ICU family members: Review and methodological challenges. West J Nurs Res 2016;38:57 78.

Li L, Nelson JE, Hanson LC, Cox CE, Carson SS, Chai EJ, et al. How surrogate decision makers for patients with chronic critical illness perceive and carry out their role. Crit Care Med 2018;46:699 704.

Lynn J. Strategies to ease the burden of family caregivers. JAMA 2014;311:1021 2.

Sundararajan K, Martin M, Rajagopala S, Chapman MJ. Posttraumatic stress disorder in close relatives of intensive care unit patients’ Evaluation (PRICE) study. Aust Crit Care 2014;27:183 7.

Askari H, Forozi M, Navidian A, Haghdost A. Psychological reactions of family members of patients in critical care unitsin Zahedan. J Res Health 2013;3:317 24.

Chang PY, Wang HP, Chang TH, Yu JM, Lee SY. Stress, stress related symptoms and social support among Taiwanese primary family caregivers in intensive care units. Intensive Crit Care Nurs 2018.

Alfheim HB, Rosseland LA, Hofsø K, Småstuen MC, Rustøen T. Multiple symptoms in family caregivers of intensive care unit patients. J Pain Symptom Manage 2018;55:387 94.

Alfheim HB, Hofsø K, Småstuen MC, Tøien K, Rosseland LA, Rustøen T. Post traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study. Intensive Crit Care Nurs 2019;50:5 10.

McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk for dying. Crit Care Med 2010;38:1078 85.

Pourmemari M, Khaleghdoost Mohammadi T, Askandari F, Avazeh A. Study on effective factors on patients’ family members anxiety in intensive care units. ZUMS J 2010;18:91 101.

Fumis RRL, Ranzani OT, Faria PP, Schettino G. Anxiety, depression, and satisfaction in close relatives of patients in an open visiting policy intensive care unit in Brazil. J Crit Care 2015;30:440. e441 440. e446.

Schmidt M, Azoulay E. Having a loved one in the ICU: The forgotten family. Curr Opin Crit Care 2012;18:540 7.

Netzer G, Sullivan DR. Recognizing, naming, and measuring a family intensive care unit syndrome. Annl Am Thorac Soc 2014;11:435 41.

Davidson JE. Time for a formal assessment, treatment, and referral structure for families of intensive care unit patients. Crit Care Med 2012;40:1675 1676.

Saeid Y, Salaree MM, Ebadi A, Moradian ST. Family Intensive Care Unit Syndrome (FICUS): Letters to the editor. 2018;12:1-3.

Brown D, Edwards H, Seaton L, Buckley T. Lewis’s Medical surgical Nursing: Assessment and Management of Clinical Problems. Elsevier Health Sciences; 2015.

Whittemore R, Knafl K. The integrative review: Updated methodology. J Adv Nurs 2005;52:546 53.

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The strengthening the reporting of observational studies in epidemiology (STROBE) Statement: Guidelines for reporting observational studies. Int J Surg 2014;12:1495 9.

Williams V, Boylan A M, Nunan D. Critical appraisal of qualitative research: Necessity, partialities and the issue of bias. BMJ Evid Based Med 2020;25:9 11.

Aravagiri A, Bhatti W, Okereke J, Verceles AC. Identifying, Analyzing, and Combating Family Intensive Care Unit Syndrome in Long Term Acute Care Hospitals. In: Families in the Intensive Care Unit. Springer; 2018:161 177.

Petrinec A. Post–intensive care syndrome in family decision makers of long term acute care hospital patients. Am J Crit Care 2017;26:416 22.

Anderson WG, Arnold RM, Angus DC, Bryce CL. Posttraumatic stress and complicated grief in family members of patients in the intensive care unit. J Gen Intern Med 2008;23:1871 6.

McPeake J, Devine H, MacTavish P, Fleming L, Crawford R, Struthers R, et al. Caregiver strain following critical care discharge: An exploratory evaluation. J Crit Care 2016;35:180 4.

Fumis RRL, Ranzani OT, Faria PP, Schettino G. Anxiety, depression, and satisfaction in close relatives of patients in an open visiting policy intensive care unit in Brazil. J Crit Care 2015;30:440.e441 440.e446.

Navidian A, Sarhadi M, Kykhaie A, Kykhah R. Psychological reactions of family members of patients hospitalized in critical care and general units compared with general population. Iran J Nurs 2014;26:16 28.

Hwang DY, Yagoda D, Perrey HM, Currier PF, Tehan TM, Guanci M, et al. Anxiety and depression symptoms among families of adult intensive care unit survivors immediately following brief length of stay. J Crit Care 2014;29:278 82.

Azoulay E, Pochard F, KentishBarnes N, Chevret S, Aboab J, Adrie C, et al. Risk of post traumatic stress symptoms in family members of intensive care unit patients. Am J Respiratory Crit Care Med 2005;171:987 94.

Jezierska N, Borkowski B, Gaszyński W. Psychological reactions in family members of patients hospitalised in intensive care units. Anaesthesiol Intensive Ther 2014;46:42 5.

Maghsoudi J, Soltani F, Pahlavanzade S, Tavakol K. Family experiences of patients admitted in intensive care unit (ICU). IJNMR 2007;12:139 45.

VandenBorn-VanZanten SA, Dongelmans DA, Dettling Ihnenfeldt D, Vink R, van der Schaaf M. Caregiver strain and posttraumatic stress symptoms of informal caregivers of intensive care unit survivors. Rehabil Psychol 2016;61:173 8.

Alfheim HB, Hofsø K, Småstuen MC, Tøien K, Rosseland LA, Rustøen T. Post traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study. Intensive Crit Care Nurs 2019;50:5 10.

Trevick SA, Lord AS. Post traumatic stress disorder and complicated grief are common in caregivers of neuro ICU patients. Neurocrit Care 2017;26:436 43.

KentishBarnes N, Chaize M, Seegers V, Legriel S, Cariou A, Jaber S, et al. Complicated grief after death of a relative in the intensive care unit. Eur Respir J 2015;45:1341 52.

Choi J, Tate JA, Donahoe MP, Ren D, Hoffman LA, Chasens ER. Sleep in family caregivers of ICU survivors for two months post ICU discharge. Intensive Crit Care Nurs 2016;37:11 8.

Chang PY, Wang HP, Chang TH, Yu JM, Lee SY. Stress, stress related symptoms and social support among Taiwanese primary family caregivers in intensive care units. Intensive Crit Care Nurs 2018.

Davidson JE, Harvey MA. Patient and family post–intensive care syndrome. AACN Adv Crit Care 2016;27:184 6.

Shanmugham K, Cano MA, Elliott TR, Davis M. Social problem solving abilities, relationship satisfaction and depression among family caregivers of stroke survivors. Brain Inj 2009;23:92 100.

Sullivan DR, Liu X, Corwin DS, Verceles AC, McCurdy MT, Pate DA, et al. Learned helplessness among families and surrogate decision makers of patients admitted to medical, surgical, and trauma ICUs. Chest 2012;142:1440 6.

Choi J, Hoffman LA, Schulz R, Ren D, Donahoe MP, Given B, et al. Health risk behaviors in familycaregivers during patients’ stay in intensive care units: A pilot analysis. Am J Crit Care 2013;22:41 5.

McAdam JL, Fontaine DK, White DB, Dracup KA, Puntillo KA. Psychological symptoms of family members of high risk intensive care unit patients. Am J Crit Care 2012;21:386 93.

Pochard F, Darmon M, Fassier T, Bollaert PE, Cheval C, Coloigner M, et al. Symptoms of anxiety and depression in family members of intensive care unit patients before discharge or death. A prospective multicenter study. J Crit Care 2005;20:90 6.

McAdam JL, Dracup KA, White DB, Fontaine DK, Puntillo KA. Symptom experiences of family members of intensive care unit patients at high risk of dying. Crit Care Med 2010;38:1078 85.

Choi J, Donahoe MP, Hoffman LP. Psychological and physical health in family caregivers of intensive care unit survivors: Current knowledge and future research strategies. J Korean Acad Nur 2016;46:159 67.

Plakas S, Cant B, Taket A. The experiences of families of critically ill patients in Greece: A social constructionist grounded theory study. Intensive Crit Care Nurs 2009;25:10 20.

McKiernan M, McCarthy G. Family members’ lived experience in the intensive care unit: A phemenological study. Intensive Crit Care Nurs 2010;26:254 61.

Verceles AC, Corwin DS, Afshar M, Friedman EB, McCurdy MT, Shanholtz C, et al. Half of the family members of critically ill patients experience excessive daytime sleepiness. Intensive Care Med 2014;40:1124 31.

Olding M, McMillan SE, Reeves S, Schmitt MH, Puntillo K, Kitto S. Patient and family involvement in adult critical and intensive care settings: A scoping review. Health Expect 2016;19:1183 202.

Day A, Haj Bakri S, Lubchansky S, Mehta S. Sleep, anxiety and fatigue in family members of patients admitted to the intensive care unit: A questionnaire study. Crit Care 2013;17:R91.

White A, Parotto M. Families in the intensive care unit: A guide to understanding, engaging, and supporting at the bedside. Anesth Analg 2019;129:e99.

Killgore WD. Effects of sleep deprivation on cognition. In: Progress in Brain Research. Vol 185. Elsevier; 2010. p. 105 29.

Goldfarb MJ, Bibas L, Bartlett V, Jones H, Khan N. Outcomes of patient and family centered care interventions in the ICU: A systematic review and meta analysis. Crit Care Med 2017;45:1751 61.


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